This invention relates to an interbody fusion system that is installed on a portion of the spine and serves to mechanically fuse vertebral bodies.
The evolution of daily physical demands on the human body have continued to decrease in the workplace due to great advances in industrial automation. Most jobs today involve sitting for long periods of time. During relaxed sitting, the loads on the lumbar spine are greater than during upright standing. Thus, our "sitting" work style and active sports during our leisure time have significantly increased the amount of spinal problems. Loads on the spine are produced primarily by body weight, muscle activity, and externally applied loads. Since the lumbar region is the main load bearing area of the spine, and the area where pain most commonly occurs, lumbar, as well as cervical spinal surgery has become a demanding and growing field of surgery. Also, as a result of aging, and a more recreationally active population, the number of spinal fusions performed in the U.S. has grown significantly.
The objective of spinal implants is to facilitate fusion of elements of the spine. This invention addresses this issue.
The percentage of spinal fusions (using spinal implants) has increased over the past few years but is still less than 50%. Most spinal fusions are actually candidates for spinal implants.
The spinal implant market has been the most rapidly growing segment of the orthopedic market in recent years.
The primary factors responsible for the strong growth in the use of spinal implants are innovations in the design of spinal implant devices, changing physician attitudes toward the use of such devices, and the growing number of orthopedic surgeons trained in the use of such implants.
Spinal fusions are performed to treat degenerative diseases, deformities, and trauma, but until recently, surgeons had limited implant options for treating spinal conditions. Physicians treating spinal conditions either did so without implants, or utilized basic implant devices. These devices did not, however, provide the patient with sufficient structural stability, and the fusion system and efficacy were limited.
In seeing better alternatives for spinal fusions, physicians began to use plates and screws designed primarily for use on bones in other areas of the body. Due to the perceived risk of paralysis, spinal implants were slow to become popular among physicians. Now various plate, rod and screw implants have been specifically designed for the spinal region and the efficacy of these implants have been proven. Clinical studies have shown that surgeries using spinal implants are more effective at providing structure and rigidity to the spine than surgeries in which implants are not used.
This invention is a continuation in this area of development and provides for the first time an anterior lumbar and cervical fusion fixation system which has numerous advantages over posterior and lateral spinal implant systems.
Anterior (access from the patient's stomach region) lumbar and cervical surgery allows the surgeon to remove the entire intervertebral disc, which is not possible during posterior or lateral surgery. Spinal fusion operations require removal of disk material, insertion of new graft material and mechanical fusion of the adjoining vertebrae.
Surgical operations performed to date do not allow the surgeon the means to keep the graft material in place nor does it allow the surgeon the ability of evenly distributing the loads on the graft material. The proposed anterior fusion procedure with an anterior plate captures both of these tasks.
Posterior and lateral fusion and fixation operations do not allow the surgeon total access to the vertebral inner disc and does not provide a fixation device that eliminates all bending moments.
Not having direct access to the intervertebral disk, the surgeon is unable to extract the entire disk which when inserting the graft material creates additional problems and may not remedy the problem disc. Posterior and lateral spinal operations involve working closer to the spinal cord than do anterior operations. The extra clearance gained by anterior surgery significantly reduces the chance of disrupting the spinal cord and electrical impulses.
This invention allows the surgeon full access to the vertebral intervertebral disc and once installed, the fixation device is installed closer to the center of rotational moment which significantly reduces the bending moment loads on the spine.
One object of the invention is to provide an anterior fusion mechanical fixation device that allows the surgeon full access to the intervertebral disc.
Another object of the invention is the provision of a fixation device that eliminates the need for post operative body jackets.
Yet another object of the invention is the provision for a mechanical fixation device that provides a restraint for the implanted graft material so the chance for displacement of the disc graft material is significantly reduced.
Yet another object of this invention is to provide a better mechanical stabilization method that is biomechanically sound and eliminates bending moments in the vertebral bodies.
Another object of this invention is to provide an improved method and apparatus to maintain vertebrae in a desired spatial relationship and wherein a fastener extends through transverse side surface areas on one of the vertebrae.
Another object of this invention is to provide an improved method and apparatus to maintain vertebrae in a desired spatial relationship and wherein a fastener contacts two cortical surface of a vertebra.
The novelty and key to this system is its bicortical fixation systems which allows the surgeon to install a screw into two cortical bone surfaces. No other system employs such a design and for the first time creates a significantly increased pullout strength and safety factor. Mechanical advantages include increased screw friction which reduces the risk of screw pull out, moment arm stress reduction due to closeness of fixation system to center line of rotation, ability to use smaller fixation screw hardware thus allowing smaller holes in the bone and compression device which pull the two vertebral bodies together to insure bone grafting stabilization.